| NPI | 1871613620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME92495) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NV 12184) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-09-30 |